周薇　周芳

[关键词] 溫肾活血汤;子宫内膜容受性;PCOS合并不孕;宫寒

[中图分类号] R246.3          [文献标识码] B          [文章编号] 1673-9701（2021）17-0129-03

Analysis on the effectiveness of Wenshen Huoxue Decoction in improving endometrial receptivity of PCOS patients complicated with infertility

ZHOU Wei1   ZHOU  Fang2

1.Department of Traditional Chinese Medicine and Gynecology， Women and Children′s Hospital of Hunan，Changsha 410004， China; 2.Department of Gynecology and Traditional Chinese Medicine，the Maternal and Child Health Care Hospital of Xiangtan City in Hunan Province， Xiangtan 411100， China

[Abstract] Objective To explore the effect of Wenshen Huoxue Decoction on endometrial receptivity in PCOS patients with infertility. Methods A total of 110 PCOS patients complicated with infertility admitted to the Maternal and Child Health Care Hospital of Xiangtan City and Women and Children′s Hospital of Hunan from October 2018 to August 2020 were selected and randomLy divided into the control group（n=55） and the study group（n=55）.Patients in the control group were treated with clomiphene， while those in the study group were treated with clomiphene combined with Wenshen Huoxue Decoction. The endometrial thickness， morphology and blood flow of the two groups of patients were detected by ultrasound to observe the ability of endometrium to accept embryos， and the pregnancy rate and cycle pregnancy rate of the two groups of patients were counted. Results The endometrium thickness in the study group was higher than that in the control group， and the blood flow parameters of uterine artery in the study group were lower than those in the control group（P<0.05）. The endometrial types in the study group were mainly A type and B type， and the control group was mainly B type， with statistically significant differences（P<0.05）. The pregnancy rate and cycle pregnancy rate in the study group were 65.5% and 35.0%， higher than 34.5% and 16.1% in the control group（P<0.05）. Conclusion The application of Wenshen Huoxue Decoction can obviously improve the endometrial receptivity， thus increasing the clinical pregnancy rate.Therefore，it is worthy of further promotion and application in clinic.

[Key words] Wenshen Huoxue Decoction; Endometrial receptivity; PCOS complicated with infertility; Cold womb

近年来，伴随着社会工业化进程的加剧，人们的生活方式和生活环境随之发生了极大的变化，不孕症的患病率也随之呈逐年增长的趋势[1]。多囊卵巢综合征（Polycystic ovary syndrome，PCOS）存在排卵障碍，排卵异常是导致PCOS患者不孕的主要原因。从不孕症病因筛查的结果中也可以发现，排卵性不孕的人群中PCOS患者占75%;反复妊娠失败的PCOS患者子宫内膜对胚胎接受能力下降及子宫内膜容受性降低[2]。现阶段，临床治疗不孕症的方法主要是应用诱导排卵的药物，克罗米芬（Clomiphene，CC）是常用且首选的药物，不过，克罗米芬会损伤机体子宫内膜容受性，因此，虽然具有高排卵率，但妊娠率较低[3]。而PCOS合并不孕的患者中，大部是脾肾阳虚证，属于宫寒不孕的范畴，本研究应用温肾活血汤来治疗，疗效显著，现报道如下。

1 资料与方法

1.1 一般资料

选取湘潭市妇幼保健院和湖南妇女儿童医院2018年10月至2020年8月收治的PCOS合并不孕患者110例，随机分为对照组与研究组，每组各55例。其中，对照组年龄23～43岁，平均（33.1±4.6）岁;病程2.0～7.3年，平均（4.1±1.4）年。研究组年龄22～44岁，平均（33.7±4.3）岁;病程2.3～8.0年，平均（4.5±1.2）年。两组一般资料比较，差异无统计学意义（P>0.05），具有可比性。

纳入标准：①患者符合临床《无排卵型不孕症》中的相关诊断标准;②经过各项检查，确诊为PCOS合并不孕;③患者对此次研究均知情且同意，同时，已经我院医学伦理委员会审批。排除标准：①半年内应用激素治疗者;②近期应用本研究所用药物的同类药物治疗者;③患有精神障碍或认知障碍者;④患有严重心、肝、肾等脏器障碍者;⑤由于其他器质性原因引发的不孕者;⑥临床资料不完整者。